In Value-Based Care, Telehealth’s Aim is Money Saved, Not Earned

To find value in a telehealth or mHealth program, healthcare providers must look not at how much money they’ll make, but how much they’ll save.

At the St. Louis-based Mercy health system, this means sending home about 1,300 patients this year who would have died in the hospital were it not for the health system’s telehealth services. With the elimination of some 127,000 bed days, this means the health system will save roughly $77 million in a program that costs about $15 million.

Then factor in how those patients and their families feel.

Those attending Xtelligent Media’s Value-Based Care Summit were treated to a different view of healthcare this past week in Chicago. The two-day conference offered a glimpse of the industry’s efforts to move away from a pay-for-procedure philosophy and toward an ecosystem that emphasizes outcomes and performance.

For Dr. Randall S. Moore, president of Mercy Virtual and the summit’s closing keynote speaker, the challenge lies in moving away from the concept of being reimbursed for services rendered, and moving to a system that eliminates excessive and wasted payments.

This means focusing on patient outcomes and factoring in health and wellness. And that’s where telehealth and mHealth come into play.

Moore, the head of a virtual care system that spans several states – Mercy’s three-state network and three Pennsylvania, North Carolina and Florida health systems in a hub-and-spoke telemedicine network – calls it “thinking outside the box.”

Health systems, he says, have to move away from so-called “sickness care” and toward health + care, working inside and outside the walls of the hospital or doctor’s office to promote wellness, intervene before a health crisis develops and maintain an ongoing relationship with patients.

“I think if we don’t do something different, things will come crashing down in a hard way,” he warned.

Many health systems today, Moore says, can treat a patient who walks through their doors and send him or her home in less than five days. But then they’ll just come back again when they’re sick.

“Why do we wait for people to show up in our emergency rooms?” he asked. Why not, instead, “extend what we do in the hospital into the home?”

Moore’s goal is actually an evolution of the Mercy Virtual model, which debuted in 2015 with the opening of a four-story, $300 million virtual care center. At that time the center’s goal was to target the “sickest of the sick” – the 5 percent of patients responsible for roughly 50 percent of the nation’s healthcare spend.

With that telemedicine model, Moore said, Mercy Virtual is looking to cut out about 20 percent of that 50 percent spend. On a national level, that amounts to about $3.5 trillion.

“Even in Washington, they call that real money,” he said.

Beyond that, Moore sees virtual care as another word for healthcare, and Mercy Virtual as a component of all of the health system’s services, not just critical and ICU care. He wants every department of Mercy to have a virtual health strategy, so that all patients can benefit from programs that reach out beyond the hospital to improve outcomes and reduce costs.

For a health system that derives some 80 percent of its revenues from the hospital, a plan that seeks to cut its hospitalizations in half in five years, that journey won’t be easy. And that’s where Moore says healthcare providers have to change their thinking.

Simply put, stop thinking about healthcare only in the hospital or doctor’s office. And instead of focusing on money earned, focus on money – and lives – saved. Look at lives instead of dollars.

“At the end of the day, all of us get to be patients, too,” he pointed out.